{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T04:41:34Z","timestamp":1773290494543,"version":"3.50.1"},"reference-count":38,"publisher":"American Diabetes Association","issue":"2","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2007,2,1]]},"abstract":"<jats:p>OBJECTIVE\u2014To evaluate whether nurse-directed diabetes care reduced preventable diabetes-related urgent care\/emergency room visits and hospitalizations in a minority population.<\/jats:p>\n               <jats:p>RESEARCH DESIGN AND METHODS\u2014Diabetic patients who receive care in a county public health clinic were randomly selected for a Diabetes Managed Care Program (DMCP) in which a specially trained nurse followed detailed treatment algorithms to provide diabetes care for 1 year. Preventable diabetes-related urgent care\/emergency room visits and hospitalizations for these patients incurred during the intervention year and the year before enrollment were compared. Preventable diabetes-related causes were defined as metabolic (diabetic ketoacidosis, hyperglycemia, or hypoglycemia) or infection (cellulitis, foot ulcer, osteomyelitis, fungal infection, or urinary tract infection).<\/jats:p>\n               <jats:p>RESULTS\u2014Use of the urgent care\/emergency room and hospitalizations during the intervention year and the year prior were available for 331 patients who completed the DMCP intervention. There were 94 total urgent care\/emergency room visits and hospitalizations in the year before entering the DMCP and 46 during the DMCP year, a 51% reduction. Preventable diabetes-related episodes were far fewer. During the prior year, 14 patients made 15 urgent care\/emergency room visits and 5 patients incurred 6 hospitalizations. During the DMCP year, four different patients made five emergency room\/urgent care visits and one other patient was hospitalized. Preventable diabetes-related use was significantly (P &amp;lt; 0.001) lower during the intervention year compared with the prior year. Total charges for urgent care\/emergency room visits and hospitalizations only (not other charges related to diabetes care) during the year before entering the DMCP were $129,176 compared with $24,630 during the DMCP year.<\/jats:p>\n               <jats:p>CONCLUSIONS\u2014When compared with usual care, nurse-directed diabetes care resulted in significantly fewer urgent care\/emergency room visits and hospitalizations for preventable diabetes-related causes. Policy makers seeking to improve diabetes care and conserve resources should seriously consider adopting this approach.<\/jats:p>","DOI":"10.2337\/dc06-2022","type":"journal-article","created":{"date-parts":[[2007,1,26]],"date-time":"2007-01-26T20:43:19Z","timestamp":1169844199000},"page":"224-227","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":48,"title":["Effect of a Nurse-Directed Diabetes Disease Management Program on Urgent Care\/Emergency Room Visits and Hospitalizations in a Minority Population"],"prefix":"10.2337","volume":"30","author":[{"given":"Mayer B.","family":"Davidson","sequence":"first","affiliation":[{"name":"Clinical Center for Research Excellence, Charles R. Drew University, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adeela","family":"Ansari","sequence":"additional","affiliation":[{"name":"Clinical Center for Research Excellence, Charles R. Drew University, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicki J.","family":"Karlan","sequence":"additional","affiliation":[{"name":"Pfizer Health Solutions, Santa Monica, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","reference":[{"key":"2022031219015748100_R1","doi-asserted-by":"crossref","unstructured":"American Diabetes Association: Standards of medical care in diabetes\u20132006 (Position Statement). Diabetes Care\u200829(Suppl. 1): S4\u2013S42, 2006","DOI":"10.2337\/diacare.29.s1.06.s4"},{"key":"2022031219015748100_R2","doi-asserted-by":"crossref","unstructured":"Saydeh SH, Fradkin J, Cowie CC: Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes. 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